Office/Administration - Claims Processor

Coordinator - Claims

Bill Rate: $30.00. Mark up 33.05%. 13th month tenure discount 22.50%. OIG/GSA and background screenings required. $2000.00 missing equip fee if not returned. Work hours: full-time (8h day / 40 week). Standard 9am-5pm. Brand: Shared Services. Temp or Temp to Hire role: TEMP ONLY. Start date: ASAP. Length of assignment: TBD Temp. Location: 4000 Luxottica Place, Mason, OH, 45040. Onsite. Hybrid (3 days in office, 2 days for home).

These 4 roles will be to support a new project, Archee. As volume increases, we want to ensure we have temps in place to support the activity, and if all goes well convert them to perm.

The Claims Coordinator accurately and efficiently processes all types of claims from source documents, maintaining compliance with the insurance plan requirements and with high regard for adhering to goals for quality and claims production rates. Also performs other complex claim processing which include but not limited to Medicare/Medicaid Pend process, Corrected Claims, and running daily reports.

Major duties and responsibilities include: efficiently and accurately processing a variety of vision insurance claims or adjustments; determining any special plan requirements prior to billing; reviewing claims before entry for completeness and compliance with business requirements; effectively and accurately reviewing images and transcribed data in the portal in preparation for auto adjudication; coordinating and completing claim error corrections; maintaining the Medicare/Medicaid Pend Claims process; participating on special project initiatives, including rework efforts as needed; understanding and quickly operationalizing processing changes resulting from new plans, benefit designs; maintaining compliance with HIPAA guidelines and regulations; working with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include Account Managers, Operations, Information Systems, Client Representatives and leadership team; assisting Team Lead in a backup lead capacity; assisting with root cause analysis of claim issues to resolve thoroughly and completely for clients; contacting stores or providers (when necessary) to obtain additional information or follow up on claims.